Prevalence and genetic variants of G6PD deficiency among two Malagasy populations living in Plasmodium vivax-endemic areas

Malaria Journal

Research

Melinda Zikursh¹  Peter A. Zimmerman¹  Seth Schulte¹  Rosalind E. Howes²  Ernest R. Chan³  John Gibson³  Brune Ramiranirina⁴  Thierry Franchard⁵  Tovonahary Angelo Rakotomanga⁵  Arsène Ratsimbasoa⁶ 

[1] Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, USA;Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, USA;Nuffield Department of Medicine, Oxford Big Data Institute, University of Oxford, Oxford, UK;Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA;National Malaria Control Programme, Ministry of Health, Antananarivo, Madagascar;National Malaria Control Programme, Ministry of Health, Antananarivo, Madagascar;Faculty of Science, University of Antananarivo, Antananarivo, Madagascar;National Malaria Control Programme, Ministry of Health, Antananarivo, Madagascar;University of Antananarivo, Antananarivo, Madagascar;

关键词: Madagascar;    Glucose-6-phosphate dehydrogenase deficiency;    G6PDd genotypes;    Primaquine;    Plasmodium vivax;   

DOI  :  10.1186/s12936-017-1771-6

 received in 2017-02-09, accepted in 2017-03-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe prevalence and variants of G6PD deficiency in the Plasmodium vivax-endemic zones of Madagascar remain unknown. The admixed African-Austronesian origins of the Malagasy population make it probable that a heterogeneous mix of genetic variants with a spectrum of clinical severity will be circulating. This would have implications for the widespread use of P. vivax radical cure therapy. Two study populations in the P. vivax-endemic western foothills region of Madagascar were selected for G6PD screening. Both the qualitative fluorescent spot test and G6PD genotyping were used to screen all participants.ResultsA total of 365 unrelated male volunteers from the Tsiroanomandidy, Mandoto, and Miandrivazo districts of Madagascar were screened and 12.9% were found to be phenotypically G6PD deficient. Full gene sequencing of 95 samples identified 16 single nucleotide polymorphisms, which were integrated into a genotyping assay. Genotyping (n = 291) found one individual diagnosed with the severe G6PD MediterraneanC563T mutation, while the remaining G6PD deficient samples had mutations of African origin, G6PD A- and G6PD A.ConclusionsDeployment of P. vivax radical cure in Madagascar must be considerate of the risks presented by the observed prevalence of G6PDd prevalence. The potential morbidity associated with cumulative episodes of P. vivax clinical relapses requires a strategy for increasing access to safe radical cure. The observed dominance of African G6PDd haplotypes is surprising given the known mixed African-Austronesian origins of the Malagasy population; more widespread surveying of G6PDd epidemiology across the island would be required to characterize the distribution of G6PD haplotypes across Madagascar.

【 授权许可】

CC BY   
© The Author(s) 2017